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Author
Topic: Syphilis (Read 9061 times)

My husband was diagnosed + in June 2008. At the same time a RPR test came back positive for syphilis. It was so devastating because we do not know where he contracted HIV or syphilis. The last year has been tough but we are doing well considering. He has been undetectable since starting Atripla in August 2008 and received 3 shots of penicillin to fight the syphilis. His subsequent RPR tests were not non reactive but his numbers were heading down that way.

One month ago we discovered a rash developing on him similar to the rash he got when first diagnosed. After a RPR test it was confirmed his syphilis had returned. His doctor said 2 things could have happened. One, he was reinfected. He has had no sexual contact with anyone since his HIV diagnosis, so we hane ruled that out. Two, the infection was not properly treated the first time around. He does remain undetectable.

We promptly got him into the doctor for another 3 rounds of penicillin. We immediately saw a disappearance of the rash and he felt better as well.

The board of health is recommending he have a spinal tap to test for neuro syphilis. After speaking to his doctor about this she feels his condition does not meet the criteria for neuro syphilis. We do trust her as she has been correct with all the advice and instructions she has given us so far.

Can anyone shed some light on what might be happening to cause a re-occurence? Also, do you agree with the doctor's opinion?

Thank you all in advance for your support!! Just FYI, I had a RPR three weeks ago and it was non reactive.

Syphilis can be notoriously difficult to treat when one also has hiv. It is quite possible that your husband's treatment wasn't aggressive enough. Some people need more than three shots - they give you a bum-bag full of antibiotics that are pumped into the body at regular intervals.

Here are three threads which contain a wealth of information and first-hand experiences of treating syphilis (including the bum-bag treatment) in the presence of hiv:

If you have any doubts about the treatment he has received, get a second opinion. Neurosyphilis and tertiary syphilis are both very serious and the possibility of having either or both should be checked out if there is ANY doubt.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

I am sure there are medical explanations to why syphilis was not treated correctly the first time.

On the otherhand, I dunno, I'm sorry, I also gingerly point out that twice in your post there are serious sexually transmitted diseases combined with - "we don't know how it happened" - so I do hope your husband is honest and you get the syphilis taken care and that's the end of that annoyance.

Logged

“From each, according to his ability; to each, according to his need” 1875 K Marx

Thank you for the holiday wishes, but I no longer celebrate Thanksgiving in the traditional way. I'm an American, but I have been living on the Isle of Man for nearly 20 years. (It's a tiny little country in the middle of the Irish Sea, aka The Rock. We're sorta-kinda part of the UK, but not really; we've got our own government and laws etc, but the UK government gets to meddle. Don't ask me! Most of the native born Manx don't fully understand the ins and outs of the arrangement either!)

I don't have any first-hand experience with syphilis, but I'd hazard a guess that he has a good chance of remaining non-reactive. I'm basing that on the fact that he now has his hiv infection under control and undetectable, and his CD4 count is fantastic. However, he'd probably be prudent to make sure his doctor is checking his syphilis status regularly, at least for a year or two. It's always better to be safe than sorry with things like this.

Good to hear that he most likely has it beat, and congratulations on the great numbers. That must have made for a very thankful Thanksgiving for you both.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

About a year prior to infection I had stage 2 syph - got two shots of penicillin (one on each cheek)... Then when I came up positive I also showed as having a highRPR so they did the three rounds of two shots each (I call them the cement butt shots).... I have not had a negative RPR - as of today it is holding at 1:4 - my ID doc says she will check again during my next quarter labs to see if either goes down or stays same --- she says as long as it stays same then no need to worry - just continue to monitor --- in the case of ur bf where it went neg then popped back up -- probably have to go with doc's suggestion --- although i'm sure there are others who may have more experience in this area then i've had ---- i know that i don't ever want to have to get a lumbar puncture, but if it would come down to it, I would have to deal with it, as I have tried to do with each little curve this disease and life's other little conditions throw my way. You and ur bf definitely have plenty of support here

HIV complicates everything and syphilis is an excellent example of how it does this.

In a patient with with normal immunue function we expect to see the RPR titre decrease four fold over a three month period following the completion of a standard treatment regimen.

So for example a 1/16 titre should have reduced to 1/4 three months after treatment in a patient with normal immune function.

It is not uncommon for a titre of 1/1 (or even 1/2) to persist following treatment even in HIV negative people and provided this doesn't change, treatment is held to be successful. A titre of 1/4 requires additional monitoring no matter what one's HIV status might be.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts